Death With Dignity? (The question of Physician Assisted Suicide)

“Agnes” had lived long enough. The disease ravaging her lungs had downsized her once vigorous lifestyle. She couldn’t spend her days “out visiting.” Her children, grandchildren, and great-grandchildren had to come to her now.  Not too long ago, just getting out of bed was a victory.

Now, even turning over left her gasping for breath. She was confined to the bed. And not her own bed. She lay in a hospital bed sucking on an oxygen mask stuck to her face 24/7. She’d had enough.

One evening she made calls to the family and to her pastor. The pastor had been eating dinner with his family when his cell rang, but he came right away. There was finality in Agnes’s voice that couldn’t be put off.

When everyone had crammed into the small hospital room, Agnes asked the pastor to read her favorite Psalm. She inhaled the words of Psalm 139 about being knit together in her mother’s womb, about being fearfully and wonderfully made, about God’s promise to always be with her.

Then she asked the pastor to pray. He did his best.

It was after the prayer that Agnes started asking members of her family to remove the oxygen mask that was keeping her alive. No one would – or could – do it.

So she raised an unsteady hand to her face. She fumbled with the mask and the bands that held it in place. She shot an exasperated look at her clan. Then she yanked off the mask.

Agnes managed a prayer, a plea, perhaps a statement of defiance: “Thy . . . will . . . be . . . done.”

Then she closed her eyes.

Anyone in the room could have replaced the mask and prolonged her life.

No one did.

Twenty minutes or so later, Agnes breathed her last. She had died on her terms.

In my roles as pastor and blogger, I’ve been asked about what has been labeled “Death with Dignity” or “Physician Assisted Suicide.” Let me first admit that I have mixed feelings about this matter. I can’t help but think of Agnes’s last minutes, nor can I disregard the other folks I have been honored to accompany in their last moments or hours. Each time I have been present at the time of death has been a holy experience. Often that final encounter has been preceded with meetings and decisions about continuing treatment, signing DNR (Do Not Resuscitate) Orders and so on. Decisions around death are burdensome in no small part because of their finality . . . there is no changing one’s mind once life has ended.

Recent inquiries about the issue of assisted suicide were spurred by the publicity attending the death of Brittany Maynard. While I am willing to address the issue, I will be cautious as to the particular situation of Brittany Maynard. While much has been reported in the press and shared directly by Ms. Maynard and her family, it is impossible to know all the details of her situation. Although it is unlikely that her family would ever read this, it would be nothing but hurtful at this point to castigate decisions made out of love. (“Christians” have done enough of that already.)  I believe that in circumstances such as these most people truly do the best they can. It is not for me to judge Brittany Maynard or her loved ones, but rather to continue to pray for them as they grieve.

After all, is what Brittany Maynard ultimately decided really that different from what Agnes chose? Both had reached a point beyond which they felt they could not endure life any more. Both made a choice to end their lives sooner than they could have been extended.

Is what Brittany Maynard chose really that different from what we chose for my mother? Alzheimer’s and other ailments had completely incapacitated her. Treatment for anything but pain was ended, and extraordinary means of providing nourishment were withdrawn. My mother died of “natural causes,” but her life certainly could have been prolonged, such as it was.

In making pronouncements we must be careful to remember that these are weighty issues freighted with not just our fears and hopes about death but with what it means to be alive. We must be careful not to judge those who come to different conclusions as they watch a loved one suffer and lose their very identity . . . or who suffer themselves.

But I believe there is a distinction, however fine, between withholding treatment and actively causing death. There is a difference between Agnes removing the mask that was providing “extra” oxygen and suffocating someone. Ceasing extraordinary medical intervention for my mom is different than administering medications that cause death.

My conviction about that difference is rooted in my faith. I believe that we are, in the words of Psalm 139, “Fearfully and wonderfully made.” I believe that we are made “imago dei” – in the very image of God.

And I believe that every human being is therefore a sacred creation.  Deliberately ending a human life is contrary to God’s desire.

I want to live in a culture that values and celebrates life, and fear that allowing the taking of life always diminishes its value. I may be wrong, but I choose to err on the side of life whether the issue is assisted suicide or abortion or the death penalty or war.

I am not someone who blithely parrots the “party line,” but I believe my denomination’s (ELCA) “Social Message on End of Life Decisions” gets it just right. Here’s an excerpt:

The integrity of the physician-patient relationship is rooted in trust that physicians will act to preserve the life and health of the patient. Physicians and other health care professionals also have responsibility to relieve suffering. This responsibility includes the aggressive management of pain, even when it may result in an earlier death.

However, the deliberate action of a physician to take the life of a patient, even when this is the patient’s wish, is a different matter. As a church we affirm that deliberately destroying life created in the image of God is contrary to our Christian conscience. While this affirmation is clear, we also recognize that responsible health care professionals struggle to choose the lesser evil in ambiguous borderline situations—for example, when pain becomes so unmanageable that life is indistinguishable from torture.

We oppose the legalization of physician-assisted death, which would allow the private killing of one person by another. Public control and regulation of such actions would be extremely difficult, if not impossible. The potential for abuse, especially of people who are most vulnerable, would be substantially increased.

Beyond what might be called an “ethics of life” that resists physician assisted suicide, I worry most about that last sentence in the quoted material. As a Christian, I am called to care especially for the people Jesus seemed most concerned about, those who have been termed “the lost, the last, and the left out.” People who are disabled or diseased or otherwise disadvantaged would be most at risk of being adversely affected by society’s acceptance of physician assisted suicide. Medical care is expensive, especially end of life care; certainly there are those who would benefit from another’s premature exit from this life.. No matter how carefully statutes are constructed that legalized physician assisted suicide, vulnerable people will most certainly be pressured to make irrevocable decisions.

The irrevocability of the decision for suicide also gives me pause. I have met many folks who have desired to end their life, but who have received treatment and gone on to live fulfilling lives full of love given and received. Of course people will find a way to commit suicide whether it is assisted by a physician or not, but the last thing we need to do in a world where depression is an unfortunate reality for many is to make taking one’s own life easier or normalized.

Perhaps the best response for those of us concerned about “death with dignity” is to do what we can to make sure everyone has the opportunity for a “life with dignity.” It is also crucial that we support movements such as hospice that are attendant to suffering of both patients and loved ones, with a goal that every death is a “death with dignity” as much as is possible; but acknowledging that “dignity” does not mean total control (which is always an illusion anyway) but rather embraced by love and compassion.

Finally, as Christians it is important to meet those who disagree with us not with judgment but with grace. Let us remember that suicide is not the, or even an, unforgivable sin. It is crucial that we listen before we preach, if we are indeed called to preach at all. We must hear the agonized suffering of those who would desire physician assisted suicide, and pray them into the hands of the Great Physician who promises an eternity free from suffering and even death, where God will wipe every tear from our eyes.

NOTE: To protect privacy, not only was “Agnes’s” name changed but also some of the details of her story were altered.

About pastordavesimpson

I'm an unexpected pastor. Why unexpected? Because no one is more surprised than me that I'm a pastor. See the "About" page on my blog for more info.
This entry was posted in Christian Living, Christianity, ELCA, End of Life, Lutheran Theology, Psalm 139 and tagged , , , , . Bookmark the permalink.

2 Responses to Death With Dignity? (The question of Physician Assisted Suicide)

  1. Anonymous says:

    My older sister was a nurse and had worked in a retirement community for years. She had witnessed many deaths. When she was terminally ill, she told me she had gathered all the pills she needed to end her life. She asked me if I would give her the meds when the time came. She did not want her daughter to do it since she was also a nurse and her license could be in jeopardy. I said yes hoping I would not have to face that situation in real life. She never mentioned it to me again although she was in hospice for 3 months. I often wonder what I would have done! I had seen her suffer terribly but I felt it was God who should decide when to call you home. I just made sure I did everything I could to make those last 3 months as good as possible for her.

    • Thank you for sharing your experience. That must have been a very difficult time. Like I said in the post, I believe most folks do the best they can in tough circumstances . . . which is why it is important to respond with grace.

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